PODIATRY

PODIATRY. Though there is little recorded early history of the podiatrist (from Greek podos, "foot," and iatros, "doctor") in Texas, early doctors in the area doubtlessly treated feet. Before the modern specialty developed, foot practitioners were called chiropodists (from Greek chiros, "hand" + podos) because they treated both feet and hands. Abraham Lincoln had his own chiropodist. The earliest known meeting of the Texas Chiropodist Society occurred on October 22, 1917, in a room donated by the Dallas Chamber of Commerce. S. W. Gillespie of Houston was appointed temporary chairman, and W. Lee Austin of Dallas acted as temporary secretary. Gillespie was elected president, Alfred Williams of Houston vice president, and W. Lee Austin of Dallas secretary-treasurer. At the time, there were no laws regulating the profession of chiropody; few colleges taught the subject, none of them in Texas. The National Association of Chiropodists had had its first convention in 1912 in Chicago. In all likelihood, most of its members had attended college. The second annual meeting of the Texas Chiropodist Society was held at the Rice Hotel in Houston on October 7–8, 1918, when the prime concern of the members was to introduce a bill in the next legislative session to provide for a state law to regulate the practice of chiropody. The first legislative attempt was introduced by Leo C. Brady of Galveston on March 5, 1919. This bill was defeated. At that time, twenty states and the District of Columbia had enacted laws regulating the practice of chiropody. The members of the Texas organization were very concerned that failure to enact a regulatory law would permit Texas to become a dumping ground for quacks. The practice act was again introduced in 1921 and met the same fate as the original one.

The bill was introduced again in 1923 in the Thirty-eighth Legislature as a part of the Texas Medical Practice Act. A physician, Dr. A. R. Shearer of Mount Belvieu (in the Seventeenth District), brought it to the floor. This bill passed both houses and subsequently was signed by the governor. Under the enabling legislation of 1923 the Chiropody Board, one of the examining boards of Texas, remained a part of the Texas Medical Board until 1939. At the time of the implementation of the first state law, about twenty-five podiatrists were practicing in the state. As of February 15, 1988, there were 713. The early leaders of the Chiropody Society of Texas had attended chiropody school or had been trained by a preceptor. When the Chiropody Practice Act was implemented in 1923, the practitioners who did not meet standards were given the same grandfathering clause that had been applied by the other licensing boards of the healing arts. As the first Texas State Board of Chiropody Examiners was a part of the Board of Medical Examiners, the members were composed of physicians and chiropodists. The physicians were S. L. Mayo, J. F. Bailey, and T. J. Crowe. The chiropodists were J. Riley Harris and J. S. Koenig. A provision of the Chiropody Act made the secretary of the State Board of Medical Examiners automatically the secretary of the chiropody board. Dr. Mayo was elected president, Dr. J. Riley Harris vice president, and Dr. T. J. Crowe secretary; Dr. J. S. Koenig was appointed assistant secretary. Governor W. Lee O'Daniel appointed the first complete Texas State Board of Chiropody Examiners in 1939. The first organizational meeting was held at the Blackstone Hotel in Fort Worth on September 22–24, 1939. The board members were doctors Marshall Harvey of Lubbock, Edward H. Kott of Austin, Clifford H. Robinson of Fort Worth, Graham A. Scuddy of Beaumont, Roy C. Bates of San Antonio, and Riley C. Armstrong of Houston. The State Board of Podiatry Examiners grants no reciprocity with any other state.

Almost from the beginning, different factions of the profession argued about terminology and the scope of the podiatrist's practice. The word chiropodist was changed by law to podiatrist by the legislature in 1967. Podiatry roots in Texas, as well as across the nation, sprang up because the medical profession of the day paid little or no attention to the common foot aches, pains, and excrescences, such as corns and calluses. No thought was seriously given to performing any form of surgery that would cause bleeding; indeed, even prescribing or administering an arch support was thought by the early practitioners themselves to be the practice of medicine and therefore something to be avoided. Significant changes in podiatry, as in all aspects of the health-care delivery system, have advanced rapidly in the past fifty years, starting with the advent of antibiotics. A 1950 attorney general's ruling stated that a chiropodist was a physician within the meaning of the Narcotic Drug Law. The Chiropody Practice Act, amended in 1951, defined a chiropodist as "anyone who treats or offers to treat any disease, physical injury or deformity or ailment of the human foot by any system or method." This definition clearly permitted Texas podiatrists to provide total foot care. The podiatrists of today hardly resemble the first chiropodists. In spite of their relatively small numbers compared to those of other health professionals such as dentists, podiatrists have been able to expand and elevate their level of responsibility farther than the founding fathers of the profession could have dreamed. It is doubtful, for instance, that the early practitioners could have imagined calling themselves doctors, prescribing and administering dangerous drugs, performing surgery, serving on the staffs of hospitals and their governing committees, using their operating rooms, using clinical diagnostic procedures such as X ray, biopsy, and blood and urine analysis, completing a minimum of seven to eight years of higher education and training before licensure, or training for one to three additional years in hospitals.

The Texas legislature passed enabling legislation to implement a school of podiatric medicine in the University of Texas System in 1973. A subsequent feasibility study conducted by Dr. Leonard Levy at the University of Texas Health Science Center at Houston proved the need of this legislation. Implementation was delayed, however, because of lack of funding. A residency in podiatry was started with the help of the Texas Podiatric Medical Association in the medical school in San Antonio in 1972 (seeUNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT SAN ANTONIO). It became one of the most sought-after postgraduate podiatric programs in the nation and has afforded the state of Texas a role of leadership in postgraduate podiatric education. The main thrust of the Texas Podiatric Medical Association has been to provide the citizens of Texas excellent foot care. This role was enhanced by Senate Bill 655 of 1985, which broadened the definition of "Medical Staff" to include qualified podiatrists on hospital staffs. The Texas Podiatric Medical Association realizes that the state needs to provide education in podiatry as in other health-care fields. Efforts to implement the enabling legislation of 1973 to establish a school of podiatry in an existing health-science center continue. See alsoHEALTH AND MEDICINE.